Individual provider Active NPI

Elaine Theresa Jurkowski, MSW, LCSW, PHD, MBA

  • Clinical Social Worker
  • Saint Charles, MO
National Provider Identifier
1235050360
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.022765 Issued in IL
Practice address
4584 Clearbrook Dr
Saint Charles, MO 63304-8719
Phone
(618) 203-9311
NPI assigned
Jul 23, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.022765 IL Primary

Addresses

Primary practice location

4584 Clearbrook Dr
Saint Charles, MO 63304-8719

Mailing address

4584 Clearbrook Dr
Saint Charles, MO 63304-8719
Phone (618) 203-9311

Other practice location 1

523 S Station Rd
Glen Carbon, IL 62034-2748
Phone (618) 203-9311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1784764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1235050360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4584 CLEARBROOK DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048719",
            "telephone_number": "618-203-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4584 CLEARBROOK DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633048719",
            "telephone_number": "618-203-9311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "523 S Station Rd",
            "address_purpose": "LOCATION",
            "city": "Glen Carbon",
            "state": "IL",
            "postal_code": "620342748",
            "country_code": "US",
            "telephone_number": "618-203-9311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JURKOWSKI",
        "first_name": "ELAINE",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "MSW, LCSW, PHD,  MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.